0001209191-12-043465.txt : 20120828 0001209191-12-043465.hdr.sgml : 20120828 20120828173238 ACCESSION NUMBER: 0001209191-12-043465 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120824 FILED AS OF DATE: 20120828 DATE AS OF CHANGE: 20120828 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Thomas Robert Bain CENTRAL INDEX KEY: 0001404477 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54192 FILM NUMBER: 121060902 MAIL ADDRESS: STREET 1: SUITE 4 LEVEL 46 2 PARK STREET CITY: SIDNEY STATE: C3 ZIP: 2000 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: REVA Medical, Inc. CENTRAL INDEX KEY: 0001496268 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 330810505 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5751 COPLEY DRIVE CITY: SAN DIEGO STATE: CA ZIP: 92111 BUSINESS PHONE: (858) 966-3000 MAIL ADDRESS: STREET 1: 5751 COPLEY DRIVE CITY: SAN DIEGO STATE: CA ZIP: 92111 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2012-08-24 0 0001496268 REVA Medical, Inc. RVA:AX 0001404477 Thomas Robert Bain 5751 COPLEY DRIVE SAN DIEGO CA 92111 1 0 0 0 Common Stock 2012-08-24 4 P 0 3000 5.64 A 30000 I Rob Thomas Superannuation Fund Common Stock 2012-08-28 4 P 0 2000 5.60 A 32000 I Rob Thomas Superannuation Fund Represents the purchase of 30,000 of the Company's Chess Depositary Interests (CDIs), trading on the Austrialian Securities Exchange. The purchase was executed in the form of CDIs, trading on the Austrialian Securities Exchange, and as such the purchase price has been converted to a USD equivalent, adjusting for the ratio of 1 share of common stock per 10 CDIs, and the exchange rate on the date of the transaction. Represents the purchase of 20,000 of the Company's Chess Depositary Interests (CDIs), trading on the Austrialian Securities Exchange. /s/ Katrina Thompson, Attorney-in-fact 2012-08-28